2006, Number 2
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ABSTRACTObjective: To demonstrate that cholecystectomy poses a greater risk in men and to determine the causes for it.
Setting: Second level health care hospital.
Design: Retrospective, observational, comparative study.
Statistical analysis: Descriptive statistics and comparison by means of Chi square.
Material and method: We reviewed the clinical records of patients subjected to cholecystectomy between January 1st, 2003 and April 30th, 2004. We analyzed gender to determine whether there is a greater risk in performing cholecystectomy in men. We took into account age, emergency or elective surgeries, surgical diagnoses, differentiating the number of patients with complications inherent to acute cholecystitis and comparing both groups, and, finally, we determined the percentage of complications and postoperative deaths.
Results: A total of 636 patients, 525 women (82.5%) and 111 men (17.4%), were included; mean age for men was 43.4 years and for women 39.12 years, 55 male patients were emergency operated and 56 electively. For women, 389 (74%) were elective and only 136 (25.9%) were emergency surgeries. In the male group, 72% (40 patients) presented complications inherent to acute cholecystitis, whereas in the female group only 57% (78 patients) had complications. The most common diagnosis in the male group for elective surgery was chronic cholelithiasis (91%), as well as in the female group with 98.2%. The most common emergency diagnosis in women was acute cholelithiasis (57 patients) and for men it was hydrocholecystis (32.7%). In total, postoperative morbidity was 11.71% for men and 6.58% for women (p = 0.122), mortality was of 0.9% for men and 0.1% for women (p = 0.778).
Conclusions: Cholecystectomy poses a greater risk in men than in women, as it is related with a larger number of emergency surgeries, presents with more severe clinical symptoms, surgical treatment is delayed, leading to a larger number of complicated patients with more technical difficulties at the time of surgery, hence, increasing morbidity.
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